Increased arterial stiffness in healthy subjects with high-normal glucose levels and in subjects with pre-diabetes

Abstract

Background: Increased fasting plasma glucose (FPG), which includes impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and diabetes, is a risk factor for arterial stiffness. While IFG is widely accepted as a cardiovascular risk factor, recent studies have argued that subjects with high-normal glucose level were characterized by a high incidence of cardiovascular disease. The purpose of this study is to investigate the relationship between FPG and arterial stiffness in non-diabetic healthy subjects.

Methods: We recruited 697 subjects who visited the health promotion center of a university hospital from May 2007 to August 2008. Age, sex, body mass index (BMI), resting heart rate, smoking habits, alcohol intake, exercise, blood pressure, medical history, FPG, lipid profile, high sensitivity C-reactive protein (hs-CRP), and Brachial-ankle pulse wave velocity (ba-PWV) were measured. We performed correlation and multiple linear regression analyses to divide the research subjects into quartiles: Q1(n=172), 65 mg/dL≤FPG<84 mg/dL; Q2(n=188), 84 mg/dL≤FPG<91 mg/dl; Q3(n=199), 91 mg/dL≤FPG<100 mg/dL; Q4(n=138), 100 mg/dL≤FPG<126 mg/dL.

Results: FPG has an independent, positive association with ba-PWV in non-diabetic subjects after correcting for confounding variables, including age, sex, BMI, blood pressure, resting heart rate, hs-CRP, lipid profile, and behavioral habits. The mean ba-PWV of the high-normal glucose group (Q3, 1384 cm/s) was higher than that of the low-normal glucose group (1303±196 cm/s vs.1328±167 cm/s, P<0.05). The mean ba-PWV value in the IFG group (1469±220 cm/s) was higher than that in the normoglycemic group (P<0.05, respectively).

Conclusions: An increase in FPG, even within the normal range, was associated with aggravated arterial stiffness. Further research is needed to determine the glycemic target value for the prevention of arterial stiffness in clinical and public health settings.

Figure 1

Mean values of brachial-ankle pulse wave velocity according to fasting plasma glucose quartile in non-diabetic healthy subjects. *P<0.05 vs. Q1 and Q2, § P<0.05 vs. Q1, Q2, and Q3, ¶ P<0.05 vs. Q1 Model 1; adjusted for age, sex. Model 2; adjusted for age, sex, systolic blood pressure, diastolic blood pressure, BMI, resting heart rate, Hs-CRP, HDL-cholesterol, and non HDL-cholesterol.